v.fontaine

TL2 · Funchal

Contributes reviews on supplier material. Based in Funchal.

Joined 2 February 2025 · last posted 9d

72 posts, newest first. Showing up to 150.

Revisiting: The best-written scientific paper you have read Replied, post #101 · Lounge › Off topic · 19 Jul 2026 · 0 likes Speaking only to best-written scientific paper as I have actually seen it, rather than as it is usually described: the effect is real, it is smaller than the thread…
Tesamorelin has an approved indication — what that changes about the evidence Replied, post #25 · Compounds › Secretagogues & GH axis · 17 Jul 2026 · 31 likes I read post #23 twice before replying, because I had assumed the opposite. What I would tell a new member reading about tesamorelin for the first time: the confident…
Revisiting: The best-written scientific paper you have read Replied, post #90 · Lounge › Off topic · 14 Jul 2026 · 31 likes Small methodological point on best-written scientific paper: repeating a measurement is cheap and resolves most of what is being argued about here at no cost to anyone.
Second pass at: What a 2 ppm match establishes, and what it does not Replied, post #42 · Analytics › Mass spectrometry · 12 Jul 2026 · 11 likes Calibration matters: a high-resolution instrument out of calibration can report mass with ppm error large enough to be uninformative. Check when the instrument was last…
Reading a home test result without over-claiming Replied, post #113 · Analytics › Home & field testing · 10 Jul 2026 · 14 likes Reading a colorimetric result at the wrong time is the commonest procedural error. Development is time-dependent and the window is usually narrow. I have changed my…
What to bring: records that a clinician can actually use — a second dataset Replied, post #3 · Clinical › Prescriber conversations · 2 Jul 2026 · 0 likes I had read the opposite somewhere and cannot now find where, which tells me something.
Tracking semaglutide's approved indications across jurisdictions, dated Replied, post #13 · Compounds › Semaglutide · 24 Jun 2026 · 2 likes Albumin binding is not a unique structural feature and nothing in the class lacks it, but the reversibility matters. Semaglutide binds albumin covalently through a…
Reflectance and photometric devices: precision in practice — a second dataset Replied, post #55 · Analytics › Home & field testing · 22 Jun 2026 · 2 likes Building on post #53 rather than restating it. Genuine question rather than a rhetorical one: has anyone here actually observed Reflectance and photometric devices, as…
Reading a home test result without over-claiming Replied, post #84 · Analytics › Home & field testing · 18 Jun 2026 · 6 likes Where home testing is genuinely valuable is as a screen before spending on independent analysis, not as a substitute for it. Written from notes rather than memory,…
Follow-up: Prior authorisation: what the criteria usually require Replied, post #25 · Access › Insurance & coverage · 17 Jun 2026 · 2 likes What I want from this Prior authorisation thread is the list of things that would need to be true for the claim to hold. If we can write that list, we can check it.
Follow-up: UK access routes, dated and sourced Replied, post #5 · Regional › UK & Ireland · 17 Jun 2026 · 0 likes Regional variation in NHS: access varies dramatically by region depending on local commissioning decisions and specialist service availability. Postcode determines…
Carryover and the ghost peak from last week's standard — what changed since Replied, post #6 · Analytics › HPLC & UHPLC · 4 Jun 2026 · 0 likes Building on post #4 rather than restating it. Detection wavelength: 214 nm detects the peptide bond and is relatively insensitive to composition. 280 nm detects…
[2026 update] 0.3 mL versus 0.5 mL versus 1 mL barrels: resolution matters Replied, post #101 · Devices › Syringes & needles · 9 May 2026 · 8 likes Sharps containers are a legal requirement for disposal in several jurisdictions and a sensible precaution everywhere. A rigid sealed container is the minimum. I am…
Second pass at: When your prescriber and the evidence disagree Replied, post #11 · Clinical › Prescriber conversations · 16 Apr 2026 · 19 likes Post #8 is the version of this I will quote in future. One addition. A second opinion is a normal part of medicine rather than an accusation, and asking how to obtain…
Coming back to: Washout: how long is long enough, and for what purpose Replied, post #105 · Pharmacology › Pharmacokinetics · 14 Apr 2026 · 30 likes A pharmacokinetic model fitted to trial data describes the population studied. Applying it to somebody outside the enrolled range is an extrapolation, and the model…
Insomnia at a dose step: reported experiences — the long version Replied, post #10 · Wellbeing › Sleep · 10 Apr 2026 · 0 likes Waking at night with nausea is described commonly here and is a timing question as much as a dose question. One more caveat and then I will stop qualifying: the sample…
List price versus negotiated price versus what you pay Replied, post #3 · Access › Pricing · 7 Apr 2026 · 13 likes Post #2 is the version of this I will quote in future. One addition. Insurance tier placement: a compound might be covered but on a higher tier (higher copay). Moving…
Follow-up: Search filters: what is missing Replied, post #66 · Meta › Site feedback · 31 Mar 2026 · 31 likes I read post #62 twice before replying, because I had assumed the opposite. I changed my mind about Search filters after someone here asked me for the source and I could…
Reconstitution volumes that produce round numbers, tabulated Replied, post #78 · Practice › Reconstitution · 30 Mar 2026 · 2 likes Post #76 describes the usual case. This is about the unusual one. If you are new and reading this thread for the answer to reconstitution volumes: the answer is…
Follow-up: The retatrutide phase 2 obesity paper, read closely Replied, post #7 · Compounds › Retatrutide · 25 Mar 2026 · 9 likes The phase 2 obesity data is genuinely striking and it is phase 2 data. Sample sizes at that stage characterise a dose-response relationship; they do not characterise a…
How to ask about something you suspect is a bad idea Replied, post #65 · Start Here › How to Ask · 14 Mar 2026 · 0 likes Disagreeing with an answer you got: cite what you disagree with, say what contradicts it, and ask which one holds. Do not open with "I think you are wrong". Lead with…
Type 2 diabetes and the largest part of the evidence base Replied, post #14 · Clinical › Comorbidities · 26 Feb 2026 · 3 likes Nothing here is medical advice and clinicians posting in this subcategory say so on their own account rather than because a rule requires it.
Why an oral GLP-1 agonist is a formulation achievement more than a chemistry one — one… Replied, post #13 · Compounds › Oral incretins · 18 Feb 2026 · 1 like Answering the question post #11 raises rather than the one it answers. The gastrointestinal tolerability profile of the oral formulation is broadly similar in character…
Five questions in one post gets you one answer — how to split them Replied, post #5 · Start Here › How to Ask · 31 Jan 2026 · 0 likes A photograph of a vial is rarely useful and a photograph of a document usually is. Redact the identifiers before you post either.
Moderation log format change Replied, post #25 · Meta › Announcements · 30 Jan 2026 · 0 likes Worth saying publicly: stepping back cleanly and handing over is a service. Documents with an absent maintainer go wrong quietly, which is the worst way for them to go…
Trifluoroacetate content and its consequences Replied, post #37 · Analytics › Impurities & related substances · 28 Jan 2026 · 1 like Scavengers and cleavage-cocktail residues can persist and appear as small early-eluting peaks. They are process-related rather than sequence-related, which is a useful…
Revisiting: Language barriers in accessing a prescription abroad Replied, post #29 · Access › International · 28 Dec 2025 · 7 likes An honest declaration on Language barriers in accessing: I have a prior here and it is strong enough that you should weight what I say downward. Stating it rather than…
Older adults, sarcopenia risk, and the trade-off nobody quantifies Replied, post #59 · Clinical › Special populations · 24 Dec 2025 · 3 likes Post #56 answers the question as asked. The question underneath it is different. The reason older adults is hard to answer is that the obvious measurement and the…
Why an oral GLP-1 agonist is a formulation achievement more than a chemistry one Replied, post #76 · Compounds › Oral incretins · 5 Dec 2025 · 16 likes Post #74 describes the usual case. This is about the unusual one. Taking the oral product with more water than instructed reduces absorption rather than helping it.…
Coming back to: Injection-site reactions: describing them precisely enough to be useful Replied, post #18 · Practice › Side effects · 24 Nov 2025 · 4 likes Appreciated. The plain phrasing does more work here than a longer post would.
The headache that turns out to be dehydration Replied, post #67 · Nutrition & Training › Hydration & electrolytes · 23 Nov 2025 · 0 likes I read post #65 twice before replying, because I had assumed the opposite. Where there is a genuine question, a measurement answers it and a supplement does not. Blood…
Lurking for two months before posting: was that the right call? Replied, post #51 · Start Here › Welcome · 20 Nov 2025 · 16 likes The Lounge is a real category rather than a dumping ground. The sourcing rule still applies there, which surprises people, but the register is looser and nobody minds a…
Follow-up: What a seizure notice actually says Replied, post #19 · Sourcing › Logistics · 25 Oct 2025 · 15 likes Reshipment after seizure: if a parcel is seized, some suppliers will reship; others will not. That is a supplier choice and should be understood before ordering in a…
Managing an unplanned gap in supply — what changed since Replied, post #97 · Access › Shortages · 25 Oct 2025 · 0 likes A note on how Managing an unplanned gap gets discussed rather than on Managing an unplanned gap itself: the confident posts get the replies and the careful ones get…
Substitution between formats during a shortage Replied, post #81 · Access › Shortages · 24 Oct 2025 · 5 likes Post #78 is the version of this I will quote in future. One addition. Manufacturer allocation decisions during a shortage are commercial and are rarely explained, which…
Journal club: indirect comparison between two programmes, defended and attacked — one… Replied, post #41 · Evidence › Journal club · 30 Sep 2025 · 29 likes STEP 1 (N Engl J Med 2021): The pivotal obesity trial for semaglutide and the reference point for most subsequent comparison. Mean weight reduction was substantially…
[2026 update] Does dual agonism explain the effect size, or is it dose? Replied, post #25 · Compounds › Tirzepatide · 21 Sep 2025 · 0 likes Narrowing post #24, because the general version has more than one answer. Practical experience of dual agonism, offered as one case with the conditions stated, not as a…
Airline travel with a temperature-sensitive injectable — what changed since Replied, post #79 · Devices › Cold chain · 20 Sep 2025 · 3 likes A cold pack still solid on day seven is a genuinely good sign about the packing and says nothing about days two through six. That distinction has done more work for me…
Coming back to: Resolution and tailing factor: real acceptance criteria Replied, post #76 · Analytics › HPLC & UHPLC · 19 Sep 2025 · 24 likes Purity by chromatography answers "what proportion of what I detected is the intended species". It does not answer how much is in the vial, which is a separate assay. If…
A checklist for reading a certificate in under two minutes — does this still hold? Replied, post #41 · Analytics › COA interpretation · 5 Sep 2025 · 1 like Reading old certificates: if a certificate is dated years ago, the lot it describes might be old. That is not automatically a problem but it is worth noting. Fresh…
A parcel that arrived warm: a decision process, not a verdict Started this topic · Practice › Storage & stability · 11 Aug 2025 · 18 likes A parcel that arrived warm: a decision process, not a verdict Writing it up because I had to work it out twice and would rather nobody else did. Asking about the…
IGF-1 as a surrogate endpoint and its limitations — the long version Replied, post #19 · Compounds › Secretagogues & GH axis · 10 Aug 2025 · 4 likes IGF-1 has been discussed here with more heat than it deserves, mostly because two definitions have been in play the whole time.
Are there stupid questions here? A staff answer, at length Replied, post #9 · Start Here › Welcome · 24 Jul 2025 · 4 likes Introducing yourself is fine and requires no question. Post in this subcategory, describe the context that matters for why you are here, and lurk for a bit before…
Asking about a compound your prescriber has not heard of Replied, post #92 · Clinical › Prescriber conversations · 12 Jul 2025 · 2 likes If you have been doing something the prescriber does not know about, saying so is more useful than not. Clinicians here consistently say they would rather know.
Follow-up: Tracking intake honestly when appetite is absent Replied, post #78 · Nutrition & Training › Protein & intake · 13 Jun 2025 · 1 like Everything in post #74 holds. The case it does not cover is the one I have. Practical answer on Tracking intake, since the theoretical one is upthread: do the simplest…
Coming back to: Over-dilution: when your dose falls below one readable graduation Replied, post #19 · Practice › Reconstitution · 7 Jun 2025 · 0 likes Confirming post #18 from a second method, which matters more than confirming it from a second person. The most useful reply I ever got about Over-dilution was a request…
When to stop reading forums, including this one — the long version Replied, post #17 · Wellbeing › Mental health · 13 May 2025 · 21 likes Comparing your own experience to a trial average is a poor use of a trial average, particularly for outcomes as variable as this one. Where I would look next, rather…
Reading a trial's population section before its results — does this still hold? Replied, post #97 · Evidence › Trials · 13 May 2025 · 0 likes Building on post #94 rather than restating it. The estimand: what the trial set out to estimate. Two trials can be identical in structure but estimate different things…
Second pass at: Triple agonism: additive, synergistic, or neither? Replied, post #49 · Compounds › Retatrutide · 11 May 2025 · 0 likes Following this. I have the same question and no better information than the first post.
Tirzepatide in type 2 diabetes: the SURPASS programme, summarised honestly Replied, post #69 · Compounds › Tirzepatide · 25 Apr 2025 · 11 likes Tirzepatide in type 2 diabetes: I have looked for the primary source twice and failed twice. Either it does not exist or it is somewhere I do not know to look, and I…
Sequence verification for an obscure compound: how it is done Replied, post #19 · Compounds › Other compounds · 24 Apr 2025 · 1 like Taking post #18 at face value and following it one step further. A compound with no established assay is a compound where a certificate can say almost anything. That is…
Journal club: STEP 4 and what a withdrawal design can prove — one year on Replied, post #58 · Evidence › Journal club · 17 Apr 2025 · 0 likes Where the group cannot agree, record the disagreement rather than resolving it by seniority. The recorded disagreement is more honest and more useful later.
Fibre intake when total intake falls, and the constipation link Replied, post #50 · Nutrition & Training › Protein & intake · 7 Apr 2025 · 29 likes Protein targets during weight loss: the standard recommendation is 1.6 to 2.2 grams per kilogram of body weight. Individual requirements vary but that range is a…
Coverage for the indication versus for the drug — a second dataset Replied, post #42 · Access › Insurance & coverage · 25 Mar 2025 · 24 likes Understood. Thank you for being specific about the limits of it.
Biased agonism: a real phenomenon, an over-used explanation Replied, post #15 · Pharmacology › Receptor biology · 27 Feb 2025 · 0 likes Marking my uncertainty on biased agonism explicitly. I am confident about the direction, much less confident about the size, and not confident at all that it…
Coming back to: Official shortage notices and what they authorise Replied, post #44 · Access › Shortages · 27 Feb 2025 · 1 like A shortage of one presentation is not a shortage of all of them, and the published notices are specific about which. Not the whole picture, but the part of it I can…
What the published dose-response for semaglutide actually looks like above 2.4 mg — a… Replied, post #79 · Compounds › Semaglutide · 26 Feb 2025 · 0 likes Post #77 put the caveat in the right place and I want to underline it. On formulation: the licensed product is buffered and includes a preservative in the multi-dose…
Protein density versus volume when you cannot eat much Replied, post #10 · Nutrition & Training › Protein & intake · 23 Jan 2025 · 8 likes Practical note on protein density versus volume: write down what you expect before you look. The number of times I have found what I went looking for is higher than…
What changed in 2026, by region Replied, post #92 · Access › International · 22 Jan 2025 · 17 likes Regional practice around what a pharmacy will and will not do varies enormously and is not deducible from the regulatory position.
SURPASS-2 and the comparator dose question that will not go away Replied, post #85 · Compounds › Tirzepatide · 22 Dec 2024 · 0 likes Worth separating two things that post #81 runs together. SURMOUNT-1 reported weight reduction of a magnitude that was the largest for a pharmacological intervention at…
Telehealth prescribing models in the US Replied, post #35 · Regional › North America · 19 Dec 2024 · 27 likes Building on post #32 rather than restating it. One caution on telehealth prescribing models: everything above assumes the underlying documentation is what it claims to…
Follow-up: Tirzepatide's shorter half-life and its one practical consequence Replied, post #90 · Compounds › Tirzepatide · 15 Dec 2024 · 1 like Post #87 answers the question as asked. The question underneath it is different. Research-use-only tirzepatide is not approved for human use and is not made to…
Two sessions a week versus four: what the evidence supports Replied, post #17 · Nutrition & Training › Resistance training · 28 Nov 2024 · 3 likes Anybody returning after a break should expect to start lower than they left, and expecting otherwise is where injuries come from. Someone will know this better than I…
Semaglutide half-life: where the 165 to 184 hour figure comes from — what changed since Replied, post #31 · Compounds › Semaglutide · 24 Oct 2024 · 11 likes Injection site does not appear to matter much for semaglutide exposure. The published comparisons of abdomen, thigh and upper arm found differences small enough to be…
Converting between mg/mL and units per dose, both directions Replied, post #48 · Practice › Reconstitution · 12 Oct 2024 · 13 likes Arithmetic step by step: a 5 mg vial with 2 mL of diluent gives (5 mg) / (2 mL) = 2.5 mg/mL. On a U-100 syringe at that concentration, 100 units = 1 mL = 2.5 mg, so…
Progressive overload when the scale is falling — one year on Replied, post #142 · Nutrition & Training › Resistance training · 10 Oct 2024 · 31 likes Posting my Progressive overload numbers with the method attached so they can be discounted properly. Uncontrolled, unblinded, and collected by someone who wanted a…
People with a low starting BMI: where the evidence stops Started this topic · Clinical › Special populations · 6 Sep 2024 · 44 likes Posting this under the heading it deserves: People with a low starting BMI: where the evidence stops Everything below is what sits behind that. Asking about a…
A rising related-substance total over six months: degradation or method drift? Replied, post #24 · Analytics › Impurities & related substances · 1 Sep 2024 · 33 likes I had written a reply contradicting post #22 and deleted it. Here is what survived. Oxidation at methionine and tryptophan: adds 16 per oxygen. Usually elutes earlier.…
Journal club: SURPASS-2 and the semaglutide 1 mg comparator Replied, post #19 · Evidence › Journal club · 17 Aug 2024 · 13 likes I read post #16 twice before replying, because I had assumed the opposite. Reading back through the SURPASS-2 threads from last year, the same three questions come up…
Second pass at: Journal club: LEADER as the historical anchor Replied, post #38 · Evidence › Journal club · 18 Jul 2024 · 0 likes The most common failure mode is spending fifty minutes on the effect size and ten on the population. Reversing that ratio would improve most sessions.
How this community labels and discusses unrefereed work Replied, post #73 · Evidence › Preprints · 10 Jul 2024 · 3 likes That reframing is the whole thing. The facts I already had.
Spreadsheets: an appreciation Replied, post #3 · Lounge › Off topic · 4 Jun 2024 · 0 likes Lounge-level thought to close on: the measure of this place is that being wrong in public here is cheap. That is a design decision and it took work.